Healthcare Provider Details

I. General information

NPI: 1275798241
Provider Name (Legal Business Name): CYNTHIA ANN CUNNINGHAM MFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2008
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4091 YANKEE DR
AGOURA HILLS CA
91301-3526
US

IV. Provider business mailing address

4091 YANKEE DR
AGOURA HILLS CA
91301-3526
US

V. Phone/Fax

Practice location:
  • Phone: 818-575-9049
  • Fax:
Mailing address:
  • Phone: 818-575-9049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number34049
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: